High waist circumference is a risk factor for hypertension in normal‐weight or overweight individuals with normal metabolic profiles

This study aims to investigate the relationship between waist circumference and hypertension risk in normal-weight/overweight individuals with normal cardiometabolic profiles. The authors included 7217 normal-weight and overweight individuals with normal cardiometabolic profiles from the 2001 to 2014 US National Health and Nutrition Examination Survey. The authors summarized demographic characteristics, cardiometabolic profiles, and behavioral factors across waist circumference quartiles. Then, in the logistic regression analysis, the authors observed a positive and significant association between waist circumference (as a continuous variable) and the prevalence of hypertension in all three models (nonadjusted, minimally adjusted, and fully adjusted), with odds ratios (95% confidence intervals) of 1.76 (1.65-1.86), 1.29 (1.20-1.39), and 1.24 (1.09-1.40), respectively. When analyzed as a categorical variable, individuals in the highest waist circumference group had a 1.48-fold increased risk of hypertension than the lowest group in the fully adjusted model. Moreover, the Cox regression analysis revealed a positive and significant association between waist circumference and all-cause mortality in individuals with hypertension in the nonadjusted model (HR, 1.27; 95% CI, 1.10-1.47) and the fully adjusted model (HR, 1.59; 95% CI, 1.22-2.06). In conclusions, our results showed that, even in those with normal metabolic profiles, high waist circumference was significantly associated with the increased prevalence of hypertension. And once hypertension has been established, patients with high waist circumference showed elevated all-cause mortality. Therefore, waist circumference should be routinely measured and controlled regardless of metabolic profiles.